Lifestyle-related risk factors for stomach cancer in northeast Thailand.

BACKGROUND: Stomach cancer is not common in Thailand but the life styles of the Thai population are changing to become more Western so that information for planning control programme of stomach cancer is necessary. The highest incidence rates of this neoplasm are found in Eastern Asia, ranging from age-standardized rates of 95.5/105 (men) and 40.1/105 (women) in Yamagata, Japan to 4.1/105 (men) and 2.1/105 (women) in Khon Kaen, Northeast of Thailand. In Thailand, the estimated age-standardized incidence rates in 1993, 1996 were 4.9/105, 4.1/105 in men and 3.0/105 , 2.6/105 in women. Risk factors for stomach cancer in Thai population are unclear, but possibly include low intake of vegetables and fruits, alcohol drinking, tobacco smoking and high intake of salt. OBJECTIVE: To investigate various aspects of dietary factors, smoking, and alcohol drinking in determining risk of stomach cancer in Thai population. METHODS: A case-control study was conducted in Khon Kaen, Thailand during 2002-2006, to study the role of these factors in stomach cancer. 101 stomach cancer cases and 202 matched controls (case : control = 1:2) by sex, age (? 3 years) and region were recruited from Srinagarind Hospital and Khon Kaen Regional Hospital, in Khon Kaen Province. All of cases were histologically confirmed. Controls had a variety of diseases, the main ones being disease of the eye. Information on dietary habits, alcohol drinking and smoking were collected by a structured questionnaire, blood samples were collected for further study. RESULTS: The distribution of the general characteristics by case-control status, the distribution of age and sex were similar in cases and controls. In the final analysis, the factors that found to be higher risk but not statistically significant were long-term filter cigarette smoking (OR=1.9, 95%CI: 0.85-4.50), long-term alcohol consumption (OR=1.2, 95%CI: 0.51-2.60) and low intake of vegetables and fruits (OR=1.2, 95%CI: 0.74-1.96). A high intake of vegetable oil (OR=4.5, 95%CI: 1.00.-20.17) was found to be associated with increased risk, and similar tendencies were noted for pork oil (OR=1.4, 95%CI: 0.63-3.01) and jeaw prik (mainly chilly with plara broth) (OR=1.2, 95%CI: 0 .76- 2.01). CONCLUSION: Our study confirmed protective effects of a high intake of fruits and vegetables against stomach cancer development and showed a high intake of sauces to increase risk of stomach cancer as in other countries in Asia.

Risk factors for colorectal cancer in northeast Thailand: lifestyle related.

BACKGROUND: The incidence of colorectal cancer is variable around the world. Hiroshima, Japan had the highest incidence in men in 1997 with an age-standardized rate of 86.7 per 100,000 and New Zealand had the highest, at 40.6 per 100,000, in women. The incidence of colorectal cancer in Thailand is rather low and the latest figures for Northeast of Thailand are 7.1 per 100,000 for men and 4.7 for women. The reasons for these differences between countries are possibly due to variation in dietary habits, alcohol drinking or other cofactors. METHODS: A case-control study was conducted in Khon Kaen, Northeast Thailand during 2002-2006 to study risk factors for colorectal cancer in a low risk area. Totals of 253 colorectal cancer cases (males 135, females 118) and 253 age- and sex-matched controls were recruited. Information on dietary habits, alcohol drinking, smoking and other information were collected by a structured questionnaire. Blood samples were collected for further study. Both univariate and multivariate analyses were carried out. RESULTS: In the final model of multivariate analysis, the significant risk factors for colorectal cancer were a family history of cancer (OR=1.9 95%CI=1.2-2.9) and meat consumption (OR=1.0 95%CI=1.0007-1.0026). For BMI, subjects with higher BMI unexpectedly had a lower risk of colorectal cancer (OR=0.5 95%CI=0.3-0.8). CONCLUSION: Our study confirmed risk factors for colorectal cancer i.e. meat consumption and cancer in the family (genetic problem). However, the results for BMI are the reverse of expected, underlining one limitation of hospital-based case-control studies, in which cases are ill and admitted to the hospital at late stage.

Factors affecting survival of cervical cancer patients treated at the radiation unit of Srinagarind Hospital, Khon Kaen University, Thailand.

This retrospective longitudinal study aimed to evaluate factors for survival of cervical cancer patients treated with radiation therapy. Information was retrieved from the medical records of 1,180 cervical cancer patients and pathologic material was reviewed to confirm the diagnosis who treated with radiation therapy at Srinagarind Hospital, Khon Kaen University between 1 January 1994 to 31 December 1999. And they were followed up until December 31, 2004. The patients current vital status was searched through hospital-based registry, the population-based cancer registry of Khon Kaen Province, the civil registration database, the Ministry of Interior and mails were sent to them. Data were analysed with the Kaplan-Meier, Log-rank test and Cox proportion hazard model. Results were found that mortality rate of 70 per 1,000 person-year. The overall 5-years survival rate was 62.5%. Median time survival was <10 years. From multivariate analyses, the factors that were statistically affected survival of cervical cancer patients included staging (p-value<0.001), hemoglobin level (p-value<0.001), interval between external and intracavitary radiation (p-value<0.001) and fractionation (p-value=0.024). Stage III was the most important risk factors of mortality risk with 1.65-fold mortality risk compared with stage I (95% CI=1.05-2.59). Patients with low hemoglobin level (< or = 10 g./dl.) was associated with 1.85-fold mortality risk compared with patients who had level >12 g./dl. (95% CI=1.40-2.44). The interval between external and intracavitary radiation >28 days was associated with 2.28-fold mortality risk compared with patients who had duration <1 day (95% CI= 1.40-2.44). The fractionation 2 faction was associated with 0.25-fold mortality risk compared with 1 fraction (95% CI=0.07-0.96).The results of study show that stage of disease, hemoglobin level, interval between external- intracavitary radiation and fractionations were factors affected survival cervical patients treated with radiation. Future prospective trials should be undertaken to confirm the validity of these factors and to elucidate their therapeutic implications.